inflammation Flashcards

1
Q

What causes the fifth cardinal sign of inflammation?

A

loss of function is caused by pain or swelling

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2
Q

what are DAMPS?
(damage associated)

A

Intracellular proteins released when plasma membrane is injured in a cell

A signal that there is serious cell damage, triggering inflammation

recognized by PRR

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3
Q

important reiteration

A

PRR’s are nonspecific and part of innate immunity

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4
Q

what is extravasation:

A

roll and squeeze allowing cells/molecules to enter interstitial from capillaries at site of infection/damage

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5
Q

note:

A

inflammation osmosis video is goated

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6
Q

How do neutrophils work?

A

Eat as many pathogens as possible then commit apoptosis (and release cytokines)

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7
Q

What causes Angiogenesis and what is it?

A

growth factors released by macrophages at the site of inflammation

Formation of new temporary blood vessels, which leave once the wound is healed

severe damage is replaced by a fibrous scar, mild damage can fully repair

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8
Q

Define antigen:

A

has to be immunogenic (causing proliferation of immune cells)

has to be reactive (antibodies can be produced against it)

ex. you could have a self antigen in autoimmune diseases

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9
Q

Incomplete antigens (HAPTEN)

A

binds with something in the body to become an antigen (like poison ivy binding to protein in our skin)

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10
Q

what is the goal of inflammation?

A

Innate immunity:
-subdue any infection
-remove necrotic debris from original injury
-restore normal function if possible

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11
Q

Acute Inflammation (Big picture)

A

first response (hours to days)

Vascular changes: dilation and increased permeability

short lived cells (neutrophils)

potent short lived mediators

sets stage for chronic inflammation

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12
Q

neutrophils and short lived mediators (acute inflam)

A

Neutrophil is the major cell involved in acute inflammation

Body improves blood flow to provide more neutrophils and mediators to the area of injury

Die within 10 hours after leaving the blood stream

Short lived mediators can damage host tissue also

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13
Q

Chronic Inflam (big picture)

A

second response (days to weeks to months to years)

monocyte become macrophages that can live as long as the host

degrades debree

orchestrates healing vs scarring

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14
Q

side note:

A

only making cards on takeaways, see powerpoint for inclusive info

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15
Q

Notes on inflammation white board image

A

Smooth muscle around vessel will relax
Mediators: clotting factors, kininogens, complement

Mast cells live in the tissue and contain lots of granules: release histamine (main), leukotrienes, prostaglandins (anti-prostaglandin meds?antihistamines?)
-mast cells also start cascade of inflammation

Tissue damage leads to release of endotoxin which stimulates mast cell to degranulate, releasing chemotaxins (draw cells to the area)
also release of bradykinin which stimulates pain receptors (swelling also causes pressure on receptors –> pain)
Mast cell released histamine causes vasodilation of smooth muscle surrounding area of interest, leading to increased blood flow + redness and warmth
also causes increased permeability of capillaries

Selectins are like nets waiting inside the capillaries to catch neutrophils/monocytes/MACROPHAGES and bring them to their target location

(antihistamine prevents edema??? Look it up, would it be used in someone with chronic inflammation?)

Macrophages release interleukins and tissue necrosis factors, which cause: 1-4 on white board image
2: lymph system transports factors  vascular system  hypothalamus, which releases PGE 2: causing fever (kills bacteria, increased metabolism and healing)
too much fever kills host cells, but it’s ok to leave low grade fevers because they are killing bacteria, not yet host cells
3: liver CRP (C reactive protein): very good blood test for acute inflammation

This process works for damage to the endothelium (trauma) and bacteria (not the same for viruses)

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16
Q

What is the purpose of endothelial cell contraction?

A

increase vascular permeability

17
Q

direct endothelial injury

A

early (necrosis)
late (apoptosis)

18
Q

leukocyte-mediated damage

A

later (hours)

ROS, prostaglandins, enyzmes

19
Q

Not all vascular leakiness is created equal

A

hydrostatic pressure must be high and oncotic pressure low (low protein synthesis, high protein loss) to force molecules into interstitial spaces

Inflammation leakiness: increased endothelial permeability, endothelial damage, vasodilation and stasis

20
Q

Exudate from inflammation

A

Protein-rich fluid plus cells (because leakiness is not due to low oncotic pressure aka lack of proteins)

21
Q

Cellular response for acute inflammation:

A

neutrophil recruitment

phagocytosis and killing

mediator release (ROS, proteases, eicosanoids)

22
Q

Acute Inflammation Triggers

A

Necrotic debris

infections

denatured protein

thrombus

uric acid (breakdown of DNA)

ATP (important and shouldn’t be floating around)

23
Q

Arachidonic acid metabolites:

A

Prostaglandins
Leukotrienes
lipoxins

24
Q

Defects in Acute Inflammation:

A

Unchecked inflammation with tissue injury
abscess formation
loss of function (pneumonia)
systemic effects (sepsis)
-hypotension (due to vasodilation)
-thrombosis

25
Q

Chronic inflammation

A

an outcome of acute inflammation, causes minimal tissue injury and tissue can regenerate
-can lead to scarring
-can lead to resolution (neutralize mediator, normalize vessels, lymphatic drainage, macrophage cleanup)

26
Q

Regeneration of a scar depends on:

A

-nature of injury
-intensity of injury
-host responses (large response leaves more exudate in tissues)
-cell and tissue type (ex. heart can’t regenerate)
-matrix integrity
-stem cells available

27
Q

what is granulation tissue?

A

Scab

shows up after chronic inflammation with macrophages, followed by scar

28
Q

Inflammation followed by Regeneration

A

Chronic inflammation if followed by regeneration, no granulation tissue or scarring

29
Q

chronic inflammation and repair

A

moderate acute inflammation, recruit macrophages, angiogenesis, remodel matrix, complications of healing

30
Q

Going from acute to chronic inflammation

A

Monocytes migrate to tissues and become macrophages, which then engulf debris from neutrophil apoptosis and necrotic tissue

fluid and proteins are picked up by lymphatic system and put back into circulation

macrophages release growth factors stimulating fibroblasts to repair/create new blood vessels

some macrophages then leave by blood or lymph (some stay for next injury)

“the macrophage is the key cell for driving repair and scarring” !!!!

31
Q

What can cause chronic inflammation?

A

-Persistent injury (trauma, infection, necrosis)
-viral infection (neutrophils are no use intracellularly, so only recruit chronic inflammation cells like macrophages)
-autoimmune disorders (chronic response only)

32
Q

Mononuclear cell inflammation

A

lymphocytes and macrophages (macrophages release lots of mediators that cause nonspecific damage)

prolonged duration (weeks to years) and ongoing tissue injury

33
Q

repair:

A

angiogenesis

matrix deposition

34
Q

Macrophages:

A

cytokines and chemokines

complement and coagulation factors

proteases, oxygen metabolites, elcosanolds (prostaglandins, thromboxanes, leukotrienes)

35
Q

slide 54

A